title: Critical care issues in patients after liver transplantation.
abstract: The majority of patients who undergo liver transplantation (LT) spend some time in the intensive care unit during the postoperative period. For some, this is an expected part of the immediate posttransplant recovery period, whereas for others, the stay is more prolonged because of preexisting conditions, intraoperative events, or postoperative complications. In this review, 4 topics that are particularly relevant to the postoperative intensive care of LT recipients are discussed, with an emphasis on current knowledge specific to this patient group. Infectious complications are the most common causes of early posttransplant morbidity and mortality. The common patterns of infection seen in patients after LT and their management are discussed. Acute kidney injury and renal failure are common in post-LT patients. Kidney injury identification, etiologies, and risk factors and approaches to management are reviewed. The majority of patients will require weaning from mechanical ventilation in the immediate postoperative period; the approach to this is discussed along with the approach for those patients who require a prolonged period of mechanical ventilation. A poorly functioning graft requires prompt identification and appropriate management if the outcomes are to be optimized. The causes of poor graft function are systematically reviewed, and the management of these grafts is discussed.
authors.affiliation: Division of Infectious Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: Raymund R
authors.initials: RR
authors.lastname: Razonable
authors.forename: James Y
authors.initials: JY
authors.lastname: Findlay
authors.forename: Aisling
authors.initials: A
authors.lastname: O'Riordan
authors.forename: S Gordon
authors.initials: SG
authors.lastname: Burroughs
authors.forename: R Mark
authors.initials: RM
authors.lastname: Ghobrial
authors.forename: Banwari
authors.initials: B
authors.lastname: Agarwal
authors.forename: Andrew
authors.initials: A
authors.lastname: Davenport
authors.forename: Michael
authors.initials: M
authors.lastname: Gropper
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications; D001424:Bacterial Infections / Q000150:complications; D003422:Critical Care / Q000379:methods*; D006085:Graft Survival; D006801:Humans; D007362:Intensive Care Units; D017093:Liver Failure / Q000150:complications / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D011183:Postoperative Complications; D011184:Postoperative Period; D012121:Respiration, Artificial; D012307:Risk Factors; D016896:Treatment Outcome; D014777:Virus Diseases / Q000150:complications